Welcome to Issue #23 of Inside Scuba

Welcome to this issue of Inside Scuba! In this edition, we take a closer look at essential topics for divers and underwater enthusiasts. Special guest author Dr Doug Ebersole tells us about the connection between diving and PFOs (Patent Foramen Ovale) and what you need to know to stay safe. Discover the beauty of vertical compositions in underwater photography and explore the incredible dive sites of the Solomon Islands aboard the legendary Bilikiki. We also sit down with Jim Standing to uncover Fourth Element's inspiring journey in dive gear innovation and ocean conservation. Plus, don’t miss our Instagram Spotlight and the latest dive news from around the world. There's something for everyone in this packed issue!

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What’s happening in this edition?

• Diving and PFOs: Understanding the Risks, Diagnosis, and Treatments
• Dive News
• The Power of Verticals
• Diving the Solomon Islands: Aboard the Legendary Bilikiki
• In Conversation with Jim Standing: Fourth Element's Journey in Dive Gear and Ocean Conservation
• Instagram Spotlight
• Summary

Diving and PFOs: Understanding the Risks, Diagnosis, and Treatments

By Douglas Ebersole MD

Patent foramen ovale (PFO) is a very popular topic in scuba diving as the appreciation of its relationship to decompression sickness (DCS) becomes more widespread in the diving community. Though the incidence of DCS in recreational diving is only about 2 episodes per 10,000 dives, decompression sickness affects approximately 1000 divers per year. The presence of a PFO is felt to increase the risk 5- to 13-fold. An understanding of the link between PFO and DCS as well as various treatment options is important to all divers.

Incidence and Anatomy

The patent foramen ovale is an integral part of the normal fetal circulation. The inferior vena cava is the large vein in the abdomen that delivers deoxygenated blood from the abdomen and lower extremities to the right atrium. The placental oxygenated blood from the mother empties into the inferior vena cava of the fetus. Normally, a portion of the blood from the inferior vena cava passes from the right atrium to the left atrium through the PFO during fetal life, bypassing the fetal lungs as they are collapsed and full of fluid. At birth, the lungs expand and are used to oxygenate blood for the baby. The pulmonary blood flow increases greatly, increasing left atrial pressure. The resulting atrial pressure differences compress the septum primum against the septum secundum, functionally closing the PFO. Anatomic closure of the PFO occurs later in infancy in most people but is..

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In each issue of our newsletter, we will curate some top dive news from around the world. Links to each of the original articles are available.

Photo Tip of the Week - The Art and Importance of Vertical Shots in Underwater Photography

Among the array of compositional techniques available to photographers, vertical shots—commonly referred to as portrait—are massively underutilized. Almost all underwater photographers constantly swim across the reef holding their cameras in a horizontal (landscape) position snapping away without even thinking about it. Everything about our camera is designed to be shot in a horizontal position, and even more so underwater. The housing, the viewfinder and our arm set up all feel natural in the horizontal position. But by making the switch when needed we can literally transform out portfolio and get very different types of images.

Horizontal compositions dominate underwater photography. Mastering vertical shots can unlock new storytelling opportunities, provide diverse framing options for publication, and elevate your portfolio to professional standards.

This article dives deep into the importance of vertical shots, their use in editorial and creative contexts, and the techniques required to excel in this style of underwater photography.

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Diving the Solomon Islands: Aboard the Legendary Bilikiki

For the last 11 days I have been on board the wonderful Bilikiki Liveaboard on the Solomon Islands. I have been on a lot of different liveaboards and this ranks right up there amongst the best I have been on anywhere in the world.

My journey to the Solomons brought me in through Brisbane which offers 5 flights per week, many of the other guests had traveled in from the West coast of America through Fiji. Solomon Islands are a remote place, but it is this remote location that allows it to be an unspoiled diving paradise.

Diving on the Bilikiki Liveaboard in the Solomon Islands offers an exceptional underwater experience, with access to some of the most pristine and diverse dive sites in the Pacific. The itinerary typically includes a mix of vibrant coral gardens, dramatic drop-offs, WWII wrecks, and rich marine life, including schools of pelagics, colorful reef fish, and abundant macro critters. The remote, unspoiled reefs around destinations like Gizo, Marovo Lagoon, and the Florida Islands provide divers with clear waters, excellent visibility, and the opportunity for both drift dives along walls and relaxed, leisurely exploration in calm bays with incredible shallow coral reefs.

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In Conversation with Jim Standing: Fourth Element's Journey in Dive Gear and Ocean Conservation

Both of us—Byron and Andy—have been long-time fans of Fourth Element gear. Over in Iceland, Byron, who carries a nice layer of “bioprene” still has relied on their drysuits for years to brave the chilly waters and has always turned to their wetsuits for tropical dives. Andy, on the other hand, is not exactly known for his love of cold water (or his tolerance for it). Let’s just say he appreciates warmth more than most—and while we could call him “sensitive to the chill,” there are certainly more colorful descriptions floating around. To keep things cozy, Andy swears by the Fourth Element Proteus wetsuit, which has become his go-to solution for his, let’s say, "highly developed" need for thermal protection.

Fourth Element has carved out a unique place in the diving world—not just for creating gear that performs exceptionally well but also for making divers feel like, well, divers. Over time, their ethos has evolved beyond high-quality kit to focus on giving back, reducing their environmental footprint, and inspiring others to do the same. It’s a brand that cares as much about the planet as it does about keeping us warm and looking good underwater.

While we were at DEMA, we managed to meet up with Jim Standing, the co-founder of Fourth Element, and asked him to talk to us about his scuba diving journey, why he decided to start his company, the company’s journey and its philosophy. In this interview, Jim discusses how his childhood passion for scuba diving led to the creation of a brand that combines innovative products with environmental responsibility. Jim explains the evolution of their products, from thermal gear to sustainable swimwear made from recycled materials. It was fascinating listening to Jim emphasize the importance of sustainability in their business model, describing their efforts to reduce single-use plastics and develop eco-friendly packaging. We also asked Jim to talk about some of Fourth Elements most innovative products, including the Halo AR undersuit for drysuits and the Seeker Mask, designed specifically for diving on trim. We hope you enjoy this interview.

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This week’s Instagram Spotlight features Kolin Hansen, the creator behind Getting Salty. Kolin is passionate about showcasing the incredible marine life of the Pacific Northwest. As a certified technical diver and recreational enthusiast, Kolin earned his certifications in British Columbia's cold, emerald waters, where he developed a deep connection to the region's vibrant underwater world. Specializing in underwater photography and videography, he captures images of the diverse marine life that thrives along British Columbia’s coast, including the Giant Pacific Octopus, colorful Puget Sound King Crabs, stunning nudibranchs, and unique fish species.

Backed by a strong local dive community, Kolin’s mission is to highlight the wonders of cold-water diving and share the weird and wonderful marine life beneath British Columbia’s emerald waters with the rest of the world. Inspired by his dives, Kolin also creates a series of digital paintings that bring these creatures to life in art form. His designs are available as stickers, magnets, and other merchandise on GettingSalty.ca. Give him some love!

Summary

As we close this issue of Inside Scuba, we hope you’ve enjoyed it—from understanding the risks of PFOs to capturing stunning vertical compositions in your underwater photography. We’d love to hear your thoughts, ideas, and dive stories, so feel free to reach out. Until next time, dive safe, stay curious, and keep exploring the wonders of the underwater world!

Andy & Byron